A nearly 200-year-old teaching relationship between University Hospital and the Medical College of Georgia is back on after a brief hiatus. Whether that will keep the school from looking to Athens for an expansion depends on whom you ask.

University doctors and officials met with MCG President Daniel W. Rahn and associates Thursday morning to talk about MCG's assertions that limited clinical teaching opportunities in Augusta were forcing the school to look elsewhere.

Partly for that reason, MCG and the University of Georgia are planning a satellite campus of the MCG School of Medicine in Athens that could have about 40 students a year.

About two years ago, MCG pulled back the last of its residency rotations from University, which meant students largely would disappear because residents do much of the teaching.

But that didn't end the desire of University doctors to teach, said plastic and reconstructive surgeon Randy Smith, the chairman of governing board University Health Inc.

"We have a wealth of patients here," he told MCG officials. "We have people willing to teach. And you simply have not asked us."

MCG and University recently signed an affiliation agreement to return residents and students, though some students are rotating through on an informal basis.

Though residents can be based at a hospital, students must be assigned to individual physicians, and that has complicated things, Dr. Rahn said.

The interest from University physicians in teaching is certainly welcome, he said.

"If there's an opportunity to do that, and we're not capitalizing on that, then we're missing an opportunity," Dr. Rahn said.

But it might not be enough. Georgia already ranks 37th in terms of physicians per 100,000 people, and the state is expected to grow rapidly in the future and reach 11 million by 2015, Dr. Rahn said.

That is why he intends to increase the Augusta class size to 200 a year in addition to the Athens students.

"I believe the rate of growth in the state is such that we are going to need to progressively increase capacity," Dr. Rahn said. "That 240 students per year in public medical school slots is not the endpoint."

More than 20 percent of the clinical clerkships are done outside the Augusta area, and it takes about a year to get a practice prepped to take students, a dedicated exam room and a commitment that might scare some off, said Andy Albritton, the associate dean for administration in the School of Medicine. MCG also is competing with other schools, including some medical schools in the Caribbean that will pay community faculty, he said.

Students from across Georgia also want to have that broader off-site experience, said D. Douglas Miller, dean of the School of Medicine.

"We want people to have those opportunities all across the state," he said.

Georgia Sen. Ed Tarver, D-Augusta, said after the meeting that he felt the point was driven home that there are untapped resources in the community.

"I think there was an agreement that before we advance to satellite campuses that we need to utilize all of the clinical capacity that is available in the community where the medical school is located," he said, adding he hoped MCG would "heed that message."

University already is talking to MCG about bringing over obstetrics residents, and other learners might follow, said J. Larry Read, CEO of University Health Care System.

"We'll get something going before long, I think," he said.